“The U.S. Department of Defense (“DOD”) claims that fraud and abuse is inhibiting the ability of the Defense Health Agency (“DHA”), the agency responsible for administering TRICARE, to support and deliver “integrated, affordable, and high-quality health service to all DOD beneficiaries” and to be “a responsible steward of taxpayer dollars.” Noting that the Department of Justice (“DOJ”) has limited resources to prosecute those who commit fraud and abuse against the TRICARE program, the DOD now seeks to step in and ramp up enforcement.
On May 1, 2019, the DOD issued a proposed rule that would implement the DOD’s authority to impose civil monetary penalties (“CMPs”), as described in Section 1128A of the Social Security Act, against providers and suppliers who commit fraud and abuse against the TRICARE program, creating the “Military Health Care Fraud and Abuse Prevention Program” (the “Program”). If the Program is finalized, TRICARE providers and suppliers would be subject not only to…” Read More Here.
Source: National Law Review, The Military Health Care Fraud and Abuse Prevention Program: The Department of Defense Issues Proposed Regulations regarding TRICARE and Civil Monetary Penalties – May 3, 2019.
